Journal Mobile Options
Table of Contents
Vol. 31, No. 2, 2011
Issue release date: March 2011
Dement Geriatr Cogn Disord 2011;31:132–138
(DOI:10.1159/000323014)

High White Matter Lesion Load Is Associated with Hippocampal Atrophy in Mild Cognitive Impairment

Eckerström C. · Olsson E. · Klasson N. · Bjerke M. · Göthlin M. · Jonsson M. · Rolstad S. · Malmgren H. · Wallin A. · Edman Å.
aInstitute of Neuroscience and Physiology and bDepartment of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Gothenburg, Sweden

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Background: Mild cognitive impairment (MCI) is a heterogeneous condition suggested as a prodromal state of Alzheimer’s disease (AD) and subcortical vascular dementia (SVD). Recent findings suggest that white matter lesions (WML) may be associated with hippocampal atrophy. The objective of the study was to examine hippocampal and WML volumes in MCI patients and to examine if WML were linked to hippocampal atrophy. Methods: The Gothenburg MCI study is a clinically based longitudinal study with biennial clinical assessments. The participants (n = 166) consist of 92 patients with stable MCI, 30 patients with converting MCI, and 44 healthy controls. WML volumes was measured manually using MRIcron. Automated segmentation of hippocampal and total white matter volumes was performed using FreeSurfer. Results: The patients converting from MCI to dementia had reduced hippocampal volume. Stable MCI patients had fewer WML and converting MCI patients had more WML compared to controls. Hippocampal volume was only correlated to WML volume (ρ = 0.57; p < 0.01) in the quartile (n = 42) with the most WML. Conclusions: Hippocampal atrophy is present in both AD and SVD. Hippocampal volume was associated with WML volume only in the high WML quartile, suggesting that the WML volume must reach a threshold before hippocampal atrophy is seen.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, Nordberg A, Backman L, Albert M, Almkvist O, Arai H, Basun H, Blennow K, de Leon M, DeCarli C, Erkinjuntti T, Giacobini E, Graff C, Hardy J, Jack C, Jorm A, Ritchie K, van Duijn C, Visser P, Petersen RC: Mild cognitive impairment: beyond controversies, towards a consensus – report of the International Working Group on Mild Cognitive Impairment. J Intern Med 2004;256:240–246.
  2. Mitchell AJ, Shiri-Feshki M: Rate of progression of mild cognitive impairment to dementia: meta-analysis of 41 robust inception cohort studies. Acta Psychiatr Scand 2009;119:252–265.
  3. Qiu C, de Ronchi D, Fratiglioni L: The epidemiology of the dementias: an update. Curr Opin Psychiatry 2007;20:380–385.
  4. Braak H, Braak E: Neuropathological stageing of Alzheimer-related changes. Acta Neuropathol 1991;82:239–259.
  5. Roman GC, Erkinjuntti T, Wallin A, Pantoni L, Chui HC: Subcortical ischaemic vascular dementia. Lancet Neurol 2002;1:426–436.
  6. Bennett DA, Schneider JA, Bienias JL, Evans DA, Wilson RS: Mild cognitive impairment is related to Alzheimer disease pathology and cerebral infarctions. Neurology 2005;64:834–841.
  7. Risacher SL, Saykin AJ, West JD, Shen L, Firpi HA, McDonald BC: Baseline MRI predictors of conversion from MCI to probable AD in the ADNI cohort. Curr Alzheimer Res 2009;6:347–361.
  8. Pathological correlates of late-onset dementia in a multicentre, community-based population in England and Wales. Neuropathology Group of the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS). Lancet 2001;357:169–175.
  9. Godin O, Maillard P, Crivello F, Alperovitch A, Mazoyer B, Tzourio C, Dufouil C: Association of white-matter lesions with brain atrophy markers: the three-city Dijon MRI study. Cerebrovasc Dis 2009;28:177–184.
  10. Appelman AP, Exalto LG, van der Graaf Y, Biessels GJ, Mali WP, Geerlings MI: White matter lesions and brain atrophy: more than shared risk factors? A systematic review. Cerebrovasc Dis 2009;28:227–242.
  11. Nordlund A, Rolstad S, Hellström P, Sjögren M, Hansen S, Wallin A: The Göteborg MCI study: mild cognitive impairment is a heterogeneous condition. J Neurol Neurosurg Psychiatry 2005;76:1485–1490.
  12. Wallin A, Edman A, Blennow K, Gottfries CG, Karlsson I, Regland B, Sjögren M: Stepwise comparative status analysis (STEP): a tool for identification of regional brain syndromes in dementia. J Geriatr Psychiatry Neurol 1996;9:185–199.
  13. Folstein MF, Folstein SE, McHugh PR: ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  14. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), ed 4. Washington, American Psychiatric Association, 1994.
  15. Reisberg B, Ferris SH, de Leon MJ, Crook T: Global Deterioration Scale (GDS). Psychopharmacol Bull 1988;24:661–663.
  16. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984;34:939–944.
  17. Erkinjuntti T, Inzitari D, Pantoni L, Wallin A, Scheltens P, Rockwood K, Roman GC, Chui H, Desmond DW: Research criteria for subcortical vascular dementia in clinical trials. J Neural Transm Suppl 2000;59:23–30.
  18. McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA, Salmon DP, Lowe J, Mirra SS, Byrne EJ, Lennox G, Quinn NP, Edwardson JA, Ince PG, Bergeron C, Burns A, Miller BL, Lovestone S, Collerton D, Jansen EN, Ballard C, de Vos RA, Wilcock GK, Jellinger KA, Perry RH: Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology 1996;47:1113–1124.
  19. Holland CM, Smith EE, Csapo I, Gurol ME, Brylka DA, Killiany RJ, Blacker D, Albert MS, Guttmann CR, Greenberg SM: Spatial distribution of white-matter hyperintensities in Alzheimer disease, cerebral amyloid angiopathy, and healthy aging. Stroke 2008;39:1127–1133.
  20. Fischl B, Salat DH, Busa E, Albert M, Dieterich M, Haselgrove C, van der Kouwe A, Killiany R, Kennedy D, Klaveness S, Montillo A, Makris N, Rosen B, Dale AM: Whole brain segmentation: automated labeling of neuroanatomical structures in the human brain. Neuron 2002;33:341–355.
  21. Fischl B, Salat DH, van der Kouwe AJ, Makris N, Ségonne F, Quinn BT, Dale AM: Sequence-independent segmentation of magnetic resonance images. Neuroimage 2004;23(suppl 1):S69–S84.
  22. Ségonne F, Dale AM, Busa E, Glessner M, Salat D, Hahn HK, Fischl B: A hybrid approach to the skull stripping problem in MRI. Neuroimage 2004;22:1060–1075.
  23. Klauschen F, Goldman A, Barra V, Meyer-Lindenberg A, Lundervold A: Evaluation of automated brain MR image segmentation and volumetry methods. Hum Brain Mapp 2009;30:1310–1327.
  24. Querfurth HW, LaFerla FM: Alzheimer’s disease. N Engl J Med 2010;362:329–344.
  25. Nishio K, Ihara M, Yamasaki N, Kalaria RN, Maki T, Fujita Y, Ito H, Oishi N, Fukuyama H, Miyakawa T, Takahashi R, Tomimoto H: A mouse model characterizing features of vascular dementia with hippocampal atrophy. Stroke 2010;41:1278–1284.
  26. DeCarli C, Murphy DG, Tranh M, Grady CL, Haxby JV, Gillette JA, Salerno JA, Gonzales-Aviles A, Horwitz B, Rapoport SI, et al: The effect of white matter hyperintensity volume on brain structure, cognitive performance, and cerebral metabolism of glucose in 51 healthy adults. Neurology 1995;45:2077–2084.
  27. Du AT, Schuff N, Chao LL, Kornak J, Ezekiel F, Jagust WJ, Kramer JH, Reed BR, Miller BL, Norman D, Chui HC, Weiner MW: White matter lesions are associated with cortical atrophy more than entorhinal and hippocampal atrophy. Neurobiol Aging 2005;26:553–559.
  28. Nordlund A, Rolstad S, Klang O, Lind K, Hansen S, Wallin A: Cognitive profiles of mild cognitive impairment with and without vascular disease. Neuropsychology 2007;21:706–712.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50